Accuracy of Hemolyzed Potassium Levels in the Emergency Department.

The Western Journal of Emergency Medicine
Matt WilsonMunish Goyal

Abstract

In the emergency department (ED), pseudohyperkalemia from hemolysis may indirectly harm patients by exposing them to increased length of stay, cost, and repeat blood draws. The need to repeat hemolyzed potassium specimens in low-risk patients has not been well studied. Our objective was to determine the rate of true hyperkalemia among low-risk, adult ED patients with hemolyzed potassium specimens. We conducted this prospective observational study at two large (129,000 annual visits) academic EDs in the mid-Atlantic. Data were collected from June 2017-November 2017 as baseline data for planned departmental quality improvement and again from June 2018-November 2018. Inclusion criteria were an initial basic metabolic panel in the ED with a hemolyzed potassium level > 5.1 milliequivalents per liter that was repeated within 12 hours, age (≥18, and bicarbonate (HCO3) > 20. Exclusion criteria were age > 65, glomerular filtration rate (GFR) < 60, creatine phosphokinase > 500, hematologic malignancy, taking potassium-sparing or angiotensin-acting agents, or treatment with potassium-lowering agents (albuterol, insulin, HCO3, sodium polystyrene sulfonate, or potassium-excreting diuretic) prior to the repeat lab draw. Of 399 encounters wit...Continue Reading

References

Mar 28, 2003·Journal of Emergency Nursing : JEN : Official Publication of the Emergency Department Nurses Association·Marian Sue Grant
May 1, 1958·The Journal of Clinical Investigation·R C HARTMANND P JACKSON
Jun 24, 2009·Archives of Internal Medicine·Lisa M EinhornJeffrey C Fink
Jun 1, 2013·North American Journal of Medical Sciences·Jaya R AsirvathamLoring Bjornson
Jun 17, 2014·The Journal of Emergency Medicine·Boris KhodorkovskyBarry Hahn

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Citations

Jul 20, 2021·Journal of Emergency Nursing : JEN : Official Publication of the Emergency Department Nurses Association·Hayley HarveyMatthew Wilson

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Methods Mentioned

BETA
blood draw

Software Mentioned

Excel

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